ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2018
Under-reported dosimetry errors due to interplay effects during VMAT dose delivery in extreme hypofractionated stereotactic radiotherapy.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- Robustness of Tumor Control Against Intrafraction Patient Motion in Lung Stereotactic Body Radiation Therapy.Advances in radiation oncology · 2026Article
- A novel audit methodology to improve detection of planning and delivery errors in passive motion management.Physics and imaging in radiation oncology · 2026Article
- Novel DCAT plans in stereotactic body radiotherapy for stage I/II centrally located non-small-cell lung cancer.Scientific reports · 2026Article
- Comprehensive plan quality assessment of simplified volumetric-modulated arc therapy for lung stereotactic body radiotherapy.Radiological physics and technology · 2025Article
- Treating early-stage centrally-located non-small cell lung cancer with DCAT-SBRT in centers lacking the VMAT technique: a comprehensive study.Frontiers in oncology · 2024Article
- STereotactic Arrhythmia Radioablation (STAR): the Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary consortium (STOPSTORM.eu) and review of current patterns of STAR practice in Europe.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Adoption of respiratory motion management in radiation therapy.Physics and imaging in radiation oncology · 2022Article
- On the reduction of aperture complexity in kidney SABR.Journal of applied clinical medical physics · 2021Article
- A robust VMAT delivery solution for single-fraction lung SABR utilizing FFF beams minimizing dosimetric compromise.Journal of applied clinical medical physics · 2020Article
- Technological quality requirements for stereotactic radiotherapy : Expert review group consensus from the DGMP Working Group for Physics and Technology in Stereotactic Radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Review
- A novel approach to SBRT patient quality assurance using EPID-based real-time transit dosimetry : A step to QA with in vivo EPID dosimetry.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Article
- Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience.Advances in radiation oncologyArticle
- Software simulation of tumour motion dose effects during flattened and unflattened ITV-based VMAT lung SBRT.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation OncologyArticle
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeRadiotherapy of extracranial metastases changed from normofractioned 3D CRT to extreme hypofractionated stereotactic treatment using VMAT beam techniques. Random interaction between tumour motion and dynamically changing beam parameters might result in underdosage of the CTV even for an appropriately dimensioned ITV (interplay effect). This study presents a clinical scenario of extreme hypofractionated stereotactic treatment and analyses the impact of interplay effects on CTV dose coverage.
methodsFor a thoracic/abdominal phantom with an integrated high-resolution detector array placed on a 4D motion platform, dual-arc treatment plans with homogenous target coverage were created using a common VMAT technique and delivered in a single fraction. CTV underdosage through interplay effects was investigated by comparing dose measurements with and without tumour motion during plan delivery.
resultsOur study agrees with previous works that pointed out insignificant interplay effects on target coverage for very regular tumour motion patterns like simple sinusoidal motion. However, we identified and illustrated scenarios that are likely to result in a clinically relevant CTV underdosage. For tumour motion with abnormal variability, target coverage quantified by the CTV area receiving more than 98% of the prescribed dose decreased to 78% compared to 100% at static dose measurement.
conclusionThis study is further proof of considerable influence of interplay effects on VMAT dose delivery in stereotactic radiotherapy. For selected conditions of an exemplary scenario, interplay effects and related motion-induced target underdosage primarily occurred in tumour motion pattern with increased motion variability and VMAT plan delivery using complex MLC dose modulation.
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